Kaz is a six year old German Shepherd who has been diagnosed with Perianal Fistula.

Perianal fistula is characterized by chronic, purulent, malodorous, ulcerating, sinus tracts in the perianal tissues. It is most common in German Shepherds and is also seen in Setters and Retrievers. Dogs older than 7 years old are at higher risk.

Etiology and Pathogenesis: The cause is unknown, although many theories have been proposed. Contamination of the hair follicles and glands of the anal area by fecal material and anal sac secretions may result in necrosis, ulceration, and chronic inflammation of the perianal skin and tissues. Affected animals may be predisposed to generalized skin problems. Hypothyroidism, an immunologic defect, or an immune-mediated component may contribute to susceptibility. The likelihood of contamination is greater in dogs with a broad-based tail; deep anal folds may cause feces to be retained within rectal glands and play a major role. The draining tracts are lined with chronic inflammatory tissue and often extend to the lumen of the rectum and anus. Infection may spread to deeper structures involving the external anal sphincter and, therefore, should be treated promptly.

Clinical Findings: In dogs, signs include attitude change, tenesmus, dyschezia, anorexia, lethargy, diarrhea, and attempts to bite and lick the anal area. Signs in cats are similar to those in dogs but may include matting of fur and sitting in the litter box.

Treatment: Until recently, management of perianal fistulae was frustrating for both veterinarians and pet owners. Surgical therapy traditionally included anal sacculectomy, in addition to destroying the diseased tissues. Surgical techniques included excision, debridement, fulguration, and cryosurgery. Amputation of the tail at its base was once advocated alone or adjunctively with other therapy. Surgery is now only recommended for fistulae resistant to medical therapy. Sequelae of surgery include fecal incontinence, rectal stricture, and recurrence. Cyclosporine has been demonstrated to be an effective treatment; it is usually administered for 16 weeks and for an additional 4 weeks after all fistulae appear to be healed. Concurrent administration of ketoconazole allows the dosage and cost of cyclosporine therapy to be reduced. Prompt treatment with cyclosporine combined with ketoconazole is recommended early in the course of the disease to reduce the likelihood of recurrence. Other aspects of medical management include the use of stool softeners to reduce dyschezia. Perianal cleansing and antibiotics may reduce inflammation.

Kaz is being given Prednisolone (steroid anti-inflamatory) and an antibiotic to treat the disease. Cyclosporin is a medication that may be of better help but it is costly. The prednisolone is relatively cheap. Kaz is sweet, mild-mannered and well-behaved. He is an indoor dog with access to outdoors in an unfenced yard. Fecal incontinence is a symptom of Perianal Fistula so frequent and easy access to outdoors would be best for Kaz. He also has occasional bouts of diarrhea and constipation. Please contact us if you are interested or know of anyone who would be interested in helping Kaz or giving him a loving home.